ADEA CCI Liaison Ledger

In our November 2009 issue, we looked at how problem-based learning was transforming the way dentistry is taught on some of our campuses. Can Team-Based Learning"™ (TBL) play a similar role? Dozens of health professions campuses offer models to explore. We decided to spotlight a fairly recent adopter, the Tulane University School of Medicine.

It has been about five years since Dr. Kevin Krane, Professor of Medicine and Vice Dean for Academic Affairs, first encountered TBL while attending a meeting of the Association of American Medical Colleges. He shared what he learned with colleagues at Tulane, and the enthusiasm he generated resulted in an invitation to Dr. Dean Parmelee to lead a TBL workshop on campus.

"To learn about TBL, you have to do it," says Dr. Krane. He credits the workshop with giving participants a real sense of how TBL works. It provided the immediate catalyst for curricular change, but he notes that the campus was already seeking a new direction because of changes in the students themselves. "They don't attend classes like they used to. They are looking to other resources and methods to gain information. They tell us they don't always need to hear it from a faculty member." TBL offered a reason for students to come to class.

About three years ago, Tulane began piloting TBL in several courses by replacing selected lectures with TBL modules. The TBL strategy requires students to learn didactic information on their own before coming to class. Faculty then use the class time previously devoted to lectures to reinforce learning, apply knowledge in a practical way, and clarify questions that arise. As promised by its proponents, TBL appeared to be enhancing student learning at Tulane and quickly took on a more prominent place in the curriculum. Today, the second-year curriculum includes an average of one TBL module per week.

Dr. Krane points out that subject exam scores at Tulane have risen in classes that employ TBL, an effect that has been corroborated by studies of its use at Wright State University, which boasts the greatest use of TBL on any health professions campus.

All this is not to say that TBL is without its challenges. Chief among these are student and faculty resistance. "Students are conditioned to walk into a class, memorize information, and spit it back," Dr. Krane observes. "With TBL, they have to work. Not all students like that." He says they can also be reluctant to take part in assessing their peers, which is an integral part of TBL.This requires a cultural change, but one that Dr. Krane believes is worth striving for. "It helps them to understand why peer evaluation is beneficial and a professional obligation."

As for their professors, Dr. Krane observes that as in any institution, some faculty see TBL as a great opportunity while others are reticent to give up methods they consider tried and true. He attributes the smooth adoption of TBL at Tulane to the presence of a core group of medical school faculty who, he says,"have really transitioned from being teachers to being educators.Given some evidence that there are better teaching methods available, they are willing to move in that direction."

Whenever new teaching methods are proposed that require a considerable investment of faculty time to create curriculum and learn new teaching methods, the issue of how that investment will be rewarded is often raised. Tulane has not altered its promotion and tenure criteria to accommodate TBL, but thanks to venues such as MedEdPORTAL®, faculty are finding opportunities for using TBL modules as evidence of scholarly activity.

Is your dental school or program utilizing TBL? If so, tell us more so we can share your work with others. Email us at adeacci@adea.org.